Diabetes in Young People

The surgery is grateful to Jack Barnard, a student at Chipping Campden School who spent a week at the surgery on work experience in June 2017, for writing this page.

Jack has written about his own experience of living with Type 1 Diabetes in the hope that it will help others.

The information presented here is for general use only and is not intended to provide personal medical advice or substitute for the advice of your doctor or Diabetes nurse. If you have questions or concerns about individual health matters or the management of your Diabetes, please contact the surgery.

Type 1 Diabetes in Children and Young People

What is type 1 diabetes?

Type 1 diabetes is a condition in which your own immune system attacks your body. It is passed by you parents through their genes. Despite this it may stay dormant in your body throughout your life time and may not affect you in any way. However, for some people it activates and this normally happens between the ages of 5 and 18.

Symptoms of type 1 diabetes

Symptoms include:

Increased thirst

Frequent urination

Bedwetting in children who previously didn't wet the bed during the night

Extreme hunger

Unintended weight loss

Irritability and other mood changes

Fatigue and weakness

Blurred vision

If you have any of symptoms of diabetes, you should contact the surgery. It doesn’t necessarily mean you have diabetes, but it’s worth checking – early diagnosis, treatment and good control are vital for good health and reduce the chances of developing serious complications.

How does having type 1 diabetes affect me?

Type 1 diabetes is when your immune system attacks the insulin producing cells in your pancreas. The pancreas is a large organ behind the stomach and next to the small intestine. The pancreas does two main things: It releases digestive enzymes into the small intestine to help us digest food and it releases the hormones insulin and glucagon into the bloodstream.

What is insulin?

Insulin acts as a key for glucose (sugar that makes up carbohydrates) in our body. It allows glucose to easily enter our muscles and organs and provide them with energy to work. Therefore if there is too much or too little insulin it can affect our blood sugar levels.

If there is not enough insulin in the blood, there will be too much glucose and this makes your blood sugar high (Hyper).

If there is too much insulin in the blood your blood sugar level decreases causing low blood sugar levels (Hypo).

There are two different types of insulin: short acting (taken before a meal or if your blood sugar is high) and long acting insulin (taken once a day or every other day) to steadily provide a small amount of insulin and replace the job of the pancreas.

What will I have to do?

Having Type 1 diabetes requires you to regulate your blood sugar by injecting insulin into your own body. In addition to this you will need to test your blood sugar regularly and either inject insulin (if blood sugar is too high) or eat food (If blood sugar is too low).

However, there are lots of new gadgets and pieces of technology that help you moitor and regulate your blood sugar, for example an insulin pump, Libre patch, insulin pen, very thin needles and an insulin metre.

What is carbohydrate counting?

Carbohydrate counting (or carb counting) is how you regulate how much insulin your body needs for a certain meal. Every person needs a different amount of insulin per meal and this depends on how many carbs are in the meal, if you are growing, hormones, recent activities and carbohydrate ratios.

Although there are many books and apps to help you count your carbs, I find the best is Carbs & Cals by Diabetes UK. To work out how many carbs a meal has all you need to do it weigh the amount of food and find it in the book or app.

Insulin is measured in units, each unit is equal to 0.01 millilitres. This shows that only a very small amount is needed to have a big impact.

What are carb ratios?

An insulin-to-carb ratio allows you to easily figure out how much of your fast-acting insulin is needed for the amount of carbohydrate you consume. The carb ratios vary depending on the time of day and recent activities.

How do I know what my blood sugar level is and what to do?

Often a person can feel whether their blood sugar level is too high or too low.

High blood sugar makes you feel tired, fatigued, thirsty, argumentative, like you need to urinate a lot and can lead to thrush if left high for a long period of time.

Therefore if it is over 6.9 you should take some action (which may be administering fast acting insulin to bring your sugar level down).

If your blood sugar level is under 4.0 you should do something (and this may be having something very sugary to eat or drink, for example dextrose energy tablets or an energy drink). After your blood sugar level has increased a small amount of high fibre food should be eaten without insulin to keep it stable.

However the best, safest and easiest way to know your blood sugar is to test it using a blood sugar monitor.

Generally hypos are a lot more severe than being hyper. When your blood sugar reaches around 50.0 it can become fatal however if your blood sugar is below 1.0 it can also be very dangerous..

What can help make this easier?

Modern gadgets can often make it easier to regulate blood sugar levels, some of these are:

Insulin pen – A pen containing a reliable vial of insulin that has a needle attached and shows the user how much insulin they are using. Some people prefer insulin pens as there is nothing attached to their body. However these still require testing your blood using a blood sugar monitor.

Insulin pump – When your blood sugar is controlled you may be offered an insulin pump. It is a small, detachable phone shaped pump attached to the body by a lead that attaches to a patch / sticker. Once the amount of carb you are eating is input onto the machine it will automatically insert the insulin painlessly over a short period of time. The pump and lead can be detached for around 40 mins but the patch stays on. The patch contains a small needle which is inserted into your body at all times although the needle can’t be felt and the patch should not fall of when doing sport. Some people prefer this as they have a phobia of needles or find it easier.
It is still necessary to check your blood sugar when you have an insulin pump.

Libre patch – this is similar to the patch for an insulin pump. The Libre patch is a small sticker like patch that is used as an easy method to test blood sugar. A small phone like object is used to receive the data from the patch. Once the monitor is passed by the patch it shows your blood sugar instantly without having to use a blood sugar monitor or finger prick.

Blood sugar monitor – This is as an alternative to the Libre patch. They hold lots of information about you and what your body needs. It has on it automatic carb ratios for different times (only the amount of carbs is needed and it works out the amount of insulin needed), a way to test blood sugar using blood sugar strips and a finger prick, a list of old blood sugar readings at different times and dates, a list of amount of insulin taken at different items and dates, a graph to show at what time your average blood sugar level is, a small microphone to tell you when to retest your blood sugar after a hypo and a way of changing the amount of insulin required after sport or during a growth spurt.

Very thin needles – These are used with an insulin pen to inject insulin painlessly into your body. They are so thin that almost no effort is needed to inject insulin.

K'Track glucose watch sensor – This device will hopefully be released in 2018. It is a watch that, using a microneedle, constantly tests your blood sugar. It can be moved around your arm without pain. This would replace the Libre and the Blood sugar monitor as it is easier and keeps a constant track of blood sugar levels.

For any extra help with dealing with Type 1 Diabetes in children or young people click here.